There are plenty of commonly known, recognised and talked about adverse health issues connected with bulimia, which may affect those with the illness. These can include hair loss, tooth decay, heart palpitations, brittle nails, lethargy, swollen salivary glands, dry skin and indigestion to name but a few; however, two major health implications which are inter-connected seem to receive virtually no mention or recognition and they appear to go relatively unnoticed, thus remaining out of people’s awareness.

The two major health issues are pelvic floor weaknesswhich can potentially lead to collapse (mainly in women), and the other often presents alongside this pelvic floor condition and is connective tissue disease. Those with bulimia or who have had bulimia often fail to realise that lack of nutrition may lead to connective tissue disease developing and this, coupled with the immense pressure within the body when sufferers self-induce vomiting when purging (following an episode of binge eating) most probably largely contributes to the pelvic floor ultimately collapsing, as pelvic tissues and muscles weaken. Once the pelvic floor weakens, the bladder, vagina and rectum which are supported by this group of muscles are no longer lifted and supported and this almost always then leads to major issues within that area of the body; with difficulty being experienced when passing stools due to rectal bulges called rectoceles; constipation issues; bladder weakness and/or incontinence; and the vagina dropping down so far that it may begin to protrude outside of the body and begin to die off as the skin from the inside dries out on the outside.

Currently, there is only one operation and approximately 10 surgeons available nationally which can address these drastic health complications and this operation is not currently widely available in the UK. It is a difficult and complicated operation to perform which involves drawing together the pelvic floor muscles through stitching and other intricate techniques, with the overall aim being to raise and support the muscles and the whole area. The procedure also involves inserting animal collagen into the pelvic region too. Currently, this procedure has only been performed for approximately the last five years with some patients already showing signs of failure and, therefore, the long term prognosis for people who undergo this operation remains unknown.

The added horror story behind this pelvic floor condition is that the likelihood of a successful outcome and longevity of the pelvic floor repair post-operation is compromised for current bulimia sufferers and ex-bulimia sufferers as they largely present with connective tissue disease in addition to the pelvic floor issues; and these factors make the pelvic floor operation a potential failure from the outset.

So, where does this leave those experiencing severe pelvic floor weakness who currently have or who have had bulimia? Are they just left incontinent or left wearing colostomy bags, or left having to perform daily colonic irrigation each morning just to get through the day without messing themselves?

These hidden dangers of bulimia must be brought into awareness, if not only to act as a deterrent from bulimia behaviours or as a motivation for recovery from bulimia, but also to make people aware of just how detrimental and harmful eating disorders as a whole can be; and that they are very real physical as well as mental illnesses.

Written by Lynn Moore; BA(Hons), Reg. MBACP, FD.
Director at Food For Thought Eating Disorders Counselling Service, Scarborough, where I am a private practice counsellor using CBT techniques to help and support those with eating disorders, weight problems, food phobias, body image concerns and anxiety.